Dental Implants

What is an Implant?

One of the most revolutionary advances in the field of dentistry over the last 50 years has been the development and generalized use of dental implants. Dental implants are artificial devices that are implanted into the jaw bones to replace the roots of teeth.

Most dental implants are similar to the shapes of the roots of front teeth. Dental implants are threaded cylinders or are cone shaped. When the implant is placed in bone, a healing process occurs. The bone next to the implant grows tight around the implant and locks it into place. This allows the implant to function like the root of a tooth.

Dental implants are remarkable substitutions for the roots of lost teeth. The dental implant is placed in the jawbone in a relatively simple procedure. In many cases, implants are placed while the individual is awake with the use of local anesthetic (freezing). In many situations, having a dental implant placed is as easy as having a filling done.

Dental implants can be used in many wonderful ways. They can act as a replacement root for a lost tooth, and a crown (cap) can be placed on top to make the final restoration look like a real tooth. Several implants can be placed when several teeth are missing to provide support for a full arch of teeth. In these situations teeth that are similar to dentures can be anchored to the implants providing great looking, comfortable teeth that function in a manner similar to natural teeth. Dental implants can also be used as anchors to allow Orthodontists to straighten teeth in difficult situations.

Whatever use applies to your situation, you will be benefiting from one of the most advanced procedures that exist today in the treatment of tooth loss.

Implants have been referred to as a third set of teeth. Dental implants can improve the quality of life for many individuals.

Implant Procedure

The placement and restoration of dental implants can occur in a wide variety of ways depending on the needs of the patient and the treatment protocols of the dentist.

The most usual procedure is for dental implants to be placed using the same freezing that is given for routine fillings, crowns or extractions. In fact, in most instances, having an implant placed is easier and less traumatic to the tissues than an extraction. If an individual is anxious or if the treatment requirements are extensive, then the use of sedation or general anesthetic may be indicated.

Implant Placement

The gums are moved back to expose just enough of the bone to allow the dentist to evaluate the bone and to complete the placement of the implant. In some situations, if the bone is wide or if a tooth has just been extracted and there is good bone, the dentist may decide to place the implant without exposing the bone. Small drills are used to make a hole in the bone the same size as the dental implant. The implant is then pushed or threaded into place. If the gums were moved to expose the bone, it will be repositioned with a few sutures.

The number, size and spacing of the implants depends upon the treatment decided by the patient and their dentist. The implants are left to heal in the bone for different lengths of time depending on the nature of the bone and the type of dental restoration. Implants placed in the front of the lower jaw can sometimes have the teeth attached immediately due to the dense and strong nature of the bone in this area. Implants placed in bone that is soft and weak may need to heal as long as 9 months. This may be the case for grafted bone or bone in the back of the mouth.

Placing teeth on the implants

Making teeth for implants depends on the number of implants placed and the design of the teeth determined by the patient and the dentist. Usually a number of appointments are required to complete the fabrication of the new teeth. The first restorative appointment involves the making of an imprint of the tissues of the mouth and the position of the implants.

To create crowns that look like teeth, an abutment is screwed into the implant. The abutment is a piece of metal that emerges through the gum and resembles a tooth that has been prepared for a crown. A normal crown is attached to the implant with either cement or a screw. This crown is the same design as a crown that would be placed on a natural tooth.

If all teeth are missing the design is different. Often a metal bar is screwed into the implants and then teeth are attached to the bar by attachments. The patient can remove these teeth. In other designs, the teeth may be screwed directly to the implants and the patient cannot remove the teeth.

There are many uses for dental implants and different types of tooth replacement. Every patient should consult their dentist for detailed information about their particular situation.

Grafting for Implants

Some patients are lacking in bone and gum tissue. There are a wide variety of materials and procedures that can be performed to recreate some of the lost tissue as part of the implant treatment.

When gum tissue is lacking, the dentist can take tissue from other areas of the mouth and graft it to areas where it is needed. Usually the tissue is taken from the roof of the mouth using local anesthetic. The tissue is moved to the area that needs to be built up to create stronger gum tissue with a more natural appearance. This new tissue may require up to 3 months to heal and mature.

When bone is lacking, it can be recreated in a variety of ways depending on the amount that has been lost. If the bone loss is small, the grafting process can be accomplished with the use of products obtained from sources other than the patient. These products are called allografts. If the bone loss is large, bone is obtained from the patient and this is called an autograft.

Allografts

When the bone loss is minimal, the bone can be rebuilt using products out of bottles that are fabricated from human bone, cow bone or from other sources. These products are produced under strict guidelines to ensure safety. They may be used to fill small contour defects in the lower and upper jaw, they may be used to fill extraction sockets and they may be used in sinus grafting procedures. These bottled bone products may require 9 months to mature into solid bone. An allograft procedure may be done under local freezing or general anesthetic.

Autografts

If the bone loss is substantial, the dentist will take bone from the patient and move it to a site where it is needed. Sources of bone include the chin, the lower jaw at the back and sometimes sites outside of the mouth, such as the hip.

Bone obtained from the patient can be grafted in all areas of the mouth to rebuild lost bone including the maxillary sinus. When the patient’s own bone is used, the healing time for the bone to mature into solid bone is about 4 months. These procedures have been done for many years and are considered routine. They may be done using local anesthesia or a general anesthetic depending on the type of procedure.

Benefits of Implant Treatment

Tooth loss takes a terrible toll in the overall health and well-being of people. A missing front tooth draws instant focus to the mouth due to the unaesthetic smile. Multiple missing teeth create a situation where the other teeth wear prematurely and become crooked. When all of the teeth are lost most people have trouble wearing their dentures as they hurt, move while eating, slip during speech. All of these problems only get worse with age depriving many people of a good quality of life in their senior years.

Single Tooth Loss

When a single tooth needs replacing an implant is often the treatment of choice. The implant, which is an artificial tooth root, is placed in the bone and a crown is place on top of the implant. This restoration often looks and functions just like a real tooth. The implant restoration stops the teeth around it from drifting and becoming crooked and it also helps the bone and the gum from collapsing as it stimulates the tissue around it in a similar fashion to a natural tooth.

Multiple Tooth Loss

Implants can serve as artificial tooth roots in any situation where enough bone is present for their placement. One implant can be placed per missing tooth and individual crowns attached. In other situations implants can be placed for some of the missing teeth where the roots used to be and bridgework can then be placed on the implants. The great benefit of this type of treatment is that the artificial teeth often look like, feel like and function like natural teeth. Any implants placed provide the added benefit of resisting bone and gum loss which is important in resisting aging of the mouth.

Total Tooth Loss

The loss of all teeth can be a tragedy. Severe bone loss over time, as a result of tooth loss makes a person look older than they are due to wrinkling around the mouth. Dentures become painful to wear and many people give up trying to eat with them. They prefer to remove their dentures at meals. As a result they become housebound and cannot experience the social pleasure of dinning in restaurants or eating with friends. Dental implants can help almost all patients who have lost all of their teeth, It is better if the patient seeks treatment before most of the bone is lost, however, with modern techniques almost all patients can be helped. If bone is plentiful, implants can be placed where the roots of the teeth used to be and crown and bridge style teeth can be made. These look like, feel like and function like natural teeth. When there is considerable bone loss, multiple implants can be placed to support artificial teeth that resemble dentures. The difference between denture like teeth supported by implants and dentures is that they function better and move less than dentures. Eating becomes a pleasure again and the teeth stay in place providing comfort, function and increased confidence. Life is wonderful again.

Bone Loss and Aging

Many individuals do not realize the terrible tragedy that occurs when a person looses their teeth. The simple pleasure of eating becomes difficult since dentures often move, hurt and simply do not chew.

The bone that used to support the teeth melts away with time and the good gum and bone that supports the dentures disappears. This means that as a person ages and more bone is lost the dentures become even less satisfactory, and remaking or relining the denture does not correct the problems. Simply put, dentures usually get worse as the years go by. In the senior years when eating is important for nutrition, is one of the pleasures in life and is an important social event, the lack of good teeth can be devastating.

Tooth loss is followed by a loss of bone in the jaws, causing premature aging. When all of the teeth are lost the bone of the upper and lower jaws shrinks dramatically and the distance from chin to the nose becomes less. As a result the muscles and skin around the mouth look older. Lines around the nose and mouth increase in number and become deeper. Jowl’s develop along the sides of the lower jaw, the chin protrudes creating what is called witches chin and the lips become thinner and older looking.

Looking older than your years can affect the way you feel about yourself and the way other people view you. Most people who have lost their teeth and surrounding bone look older than their actual years.

Save your teeth, if you don’t want to suffer eating difficulties or premature aging. If you can’t save your teeth or have already lost them, consider treatment with dental implants. Teeth supported with dental implants may be as functional as your natural teeth. Dental implants also resist bone loss in your jaws and as a result help to keep you looking young.

Implant vs. Bridge

When a tooth is lost it should be replaced. All teeth are important. Often it is difficult to decide whether to have your dentist replace your missing tooth with a bridge or an implant. Both methods are good but both have different advantages and disadvantages.

A bridge is made by using the teeth next to the missing tooth as anchors. The teeth next to the missing tooth are altered by the dentist by taking away some of the tooth structure the same way as a tooth is prepared for a crown (cap).

A bridge is made by joining the missing tooth to the capped teeth to form one piece, and is then cemented in place.

The advantages of bridges are:

Most dentists have the knowledge to make them.

They can be made quickly.

They usually provide good aesthetics.

The disadvantages of bridges are:

The anchor teeth which may have no fillings are permanently altered and may be eventually lost due to the capping process.

The capped teeth may get decay where the cap meets the tooth.

If any part of the bridge fails, the whole bridge often fails involving more than one tooth.

Implants are artificial roots that are placed in the bone. The dentist then adds a crown to the implant.

Advantages of Implants are:

Other teeth in the mouth are not altered as occurs with a bridge.

Only the space where the missing tooth is lost is involved in the treatment.

Implants help to preserve the bone in the area where they are placed.

Disadvantages of Dental Implants are:

Fewer dentists are trained to provide this service.

Dental implants take longer to complete than a bridge The choice between a bridge and an implant depends on several factors for your specific situation. Understanding the advantages and disadvantages can help you make the right decision.

Milled Bar Prostheses

When teeth are lost, the bone shrinks in height and width over time. For individuals that have lost their teeth for many years, the amount of bone loss can be significant. When considering implant treatment to replace the missing teeth, there may be some areas of the mouth where implants cannot be placed due to the amount of bone loss that has occurred.

Implants can be placed in the regions of the mouth were bone still remains or where bone can easily be grafted, however, in some areas grafting may not be possible. In these situations, a fixed implant restoration may not be an option.

A milled bar prosthesis is a wonderful option. In the lower jaw there is almost always enough bone at the front of the mouth to place 4 or 5 dental implants. In the upper jaw, implants can usually be placed in the front of the mouth or the back of the mouth, however, in the back, grafting may be required. Dental implants are placed and subsequently joined with a custom cast piece of precious metal called a bar. This bar in some designs is milled (ground) to have almost parallel sides.

The flat sides of the bar created by the milling process create surfaces that help stabilize the teeth.The teeth are fabricated to slide over the bar and lock into place. The bar will have some sort of secondary attachment mechanism that is designed by the dentist in co-ordination with the dental laboratory. The teeth will resemble a denture and will have plastic teeth and pink plastic gum to replace the lost gum tissue.

The final result is artificial teeth that fit with great stability over the milled bar. Biting forces are absorbed by the bar and transmitted to the implants. The teeth do not rest on the gums.

Milled bar implant-supported prostheses provide a wonderful way to replace lost teeth in areas of the mouth that have significant bone loss.